POS1433 OBSTETRIC OUTCOMES OF MEXICAN WOMEN WITH AUTOIMMUNE RHEUMATIC DISEASES.
Authors: L. G. Espinosa Banuelos, C. M. Skinner Taylor, L. Pérez Barbosa, A. Cárdenas, F. Hernández, A. Y. Lujano Negrete, S. M. Delgado Ayala, A. Guzman Lopez, D. Á. Galarza-Delgado
Journal: Annals of the Rheumatic Diseases (2022)

Background Autoimmune rheumatic diseases(ARDs) are more prevalent in women during childbearing age. These women have an increased risk of adverse pregnancy outcomes and maternal morbidity than general obstetric population(GOP) Objectives The objective this study was to evaluate the obstetric outcomes in Mexican women with ARDs Methods A retrospective and descriptive study was conducted in a pregnancy and rheumatic disease clinic of a university hospital in Northeast Mexico from Jan 2017 to Dec 2020. All data were collected from the medical records of childbearing age women with ARDs enrolled in our clinic at the time of their pregnancy and childbirth. Patients with non-inflammatory rheumatic diseases were excluded. The obstetric, maternal, and fetal outcomes were compared with the rate of adverse perinatal outcomes of the GOP (n=31,254) database from the same institution. Sociodemographic and clinical characteristics of the population are described. We used the Mann–Whitney U, Chi-square, or Kruskal–Wallis tests to analyze the differences between groups. A p&lt;0.05 was considered statistically significant. The statistical analysis was performed with SPSS v.24 statistical software (IBM, NY). Results A total of 62 pregnancies in women with ARDs were included. RA (n=24, 38%) was the most frequent diagnosis followed by SLE (n=14, 22.5%) and APS (n=9, 14.5%). The median maternal age at conception was higher in pregnancies with ARDs than GOP(p&lt;0.001). Table 1 shows the pregnancy and product outcomes between groups. Maternal age ≥ 35 years was also more frequent in the ARDs group(p&lt;0.001). The birth weight was lower in ARDs group than GOP(p=0.007). The odds of preterm delivery were increased in ARDs group(p=0.038) Table 1. Pregnant outcome, maternal, fetal, and neonatal adverse events ARD(n=62 ) GOP(n=31254 ) OR(CI 95% ) p Pregnancy outcome Pregnancy loss a 6(9.68) 1560(4.99) 1.94(0.84-4.49) 0.122 Live births a 60(90.9) 29694(95) 0.96(0.67-1.35) 0.8 Gestational age, median (IQR)(weeks) b 37.6(37-39) 39(38-40.2) - 0.001 Birth weight, mean (CI)(Kg) c 2831.6 (2677.4-2985.8) 3022.2 (2986.8-3057.6) - 0.007 Maternal adverse events Preterm deliveries&lt;37 weeks a 14(23.7) 3821(12.2) 1.85(1.03-3.3) 0.038 &lt;34 weeks a 3(5.1) 1065(3.4) 1.42(0.45-4.53) 0.553 Gestational diabetes a 4(6.5) 1406(4.5) 1.43(0.52-3.95) 0.485 Preeclampsia a 5(8.1) 2471(7.89) 1.02(0.41-2.54) 0.97 Postpartum hemorrhage a 0 930(2.97) 0.27(0.017-4.35) 0.355 Emergency cesarean section a 8(12.9) 1844(5.9) 2.19(1.05-4.57) 0.037 Maternal death a 0 31(0.09) 7.94(0.48-131.2) 0.148 Fetal adverse events Miscarriages a 3(4.8) 663(2.12) 2.28(0.71-7.29) 0.164 Stillbirths a 3(4.8) 897(2.87) 1.69(0.53-5.38) 0.377 Congenital anomalies a 4(6.5) 1094(3.5) 1.84(0.67-5.08) 0.237 Neonatal adverse events Low birthweight (&lt;10th percentile) a 7(12.3) 3782(12.1) 0.933(0.43-2.04) 0.862 Very low birthweight (&lt;3rd percentile) a 3(5.3) 813(2.6) 1.86(0.58-5.93) 0.294 Low Apgar scores at 5 minutes (&lt;7) a 4(7.02) 1781(5.7) 1.13(0.41-3.12) 0.81 Values in bold denote statistical significance (&lt;0.05) a n, % b IQR, interquartile range (25th–75th percentile) c CI, confidence interval (95%) The most common fetal adverse event was congenital anomalies in both groups with no significant difference(p=0.237). The most frequent neonatal adverse events were low birthweight(&lt;10th percentile) and a low Apgar score at 5 minutes(&lt;7pts) in both groups The prevalence of cesarean section was higher in the ARDs group(p=0.016). The distribution of indications for cesarean sections is shown in Figure 1. Conclusion Pregnant women with ARDs had a higher median maternal age at conception, lower birth weight, increased preterm delivery, and more emergency cesarean sections than pregnant women without ARDs. Close monitoring and multidisciplinary care are necessary to prevent and timely treat complications in this population References [1]Strouse J, et al. (2019) Impact of autoimmune rheumatic diseases on birth outcomes: a population-based study. RMD open, https://doi.org/10.1136/rmdopen-2018-00087 Disclosure of Interests None declared